Drug & Behavior Exam 4

Affective Education

an approach in substance-abuse prevention programs that helps students recognize their own feelings and express them, helping them achieve altered emotional states without drugs, and teaching them to feel valued, accepted, and wanted--> presumed to be ways of reducing drug use.

What is the BAC level in the US for DUI conviction?

0.08

AA 12 Steps

1. Admit we were powerless over alcohol 2. A power greater than ourselves can help us recover 3. Make the decision to change and turn to God 4. Create a moral inventory or ourselves 5. Admit to ourselves, others and God our wrongdoings 6. Demonstrate readiness to change for the better 7. Ask God for help 8. Make a list of everyone we harmed, make amends 9. Try to make direct amends with these people 10. Admit to being wrong, continue personal checkups 11. Maintain contact with God and ask for strength 12. Having a spiritual awakening as a result of process

Nature vs nurture in alcoholism

1. Adoption studies found slightly higher incidences of alcoholism in adopted children of alcoholic biological parents 2. Twin studies found concordance rate is less than 1 *biological inheritance contribute to alcoholism- both nature and nurture*

Liver disease as a result of heavy chronic alcohol use

1. Alcohol-related Fatty Liver: Fatty acids are usual fuel for the liver (fat deposits)-- When alcohol is present is has a higher priority and is used as fuel instead- can lead to death of liver cells 2.Alcoholic hepatitis: serious disease & includes both inflammation and impairment of liver function- this occurs in areas where the cells are dead or dying (LIVER INFLAMMATION) 3. Cirrhosis: 10 years of steady drinking (pint or more of whiskey a day) *7th leading cause of death in US* causes liver cells to be replaced with fibrous tissue (collagen), which changes the structure of the liver--> this change decreases blood flow--> results in decreased ability to function--> can lead to other infections or cancer (LIVER SCARRING)

Treatment for alcohol disorders

1. Alcoholic Anonymous (AA) 2. Motivational Enhancement: motivational interviewing that is based on helping ppl to accept the need for change and then develop strategies for implementing and maintaining their efforts to change their own behvaior 3. Cognitive-behavioral therapy: focuses on stopping and preventing negative thought patterns and learning to behave differently in the situations that have typically led to excessive drinking 4. Contingency Management: Provides incentives when participants meet certain goals, such as remaining abstient for a week

Fetal alcohol syndrome (FAS)- what are the 3 primary criteria for diagnosis? Why does FAS occur?

1. Growth retardation occurring before and/or after birth 2. A pattern of abnormal features of the face & head, (small head circumference, small eyes, or evidence of retarded formation of the midfacial area) 3. Evidence of CNS abnormality, including abnormal neonatal behavior, mental retardation, or evidence of abnormal behavioral development *occurs when BAC peak and to the duration of alcohol exposure- alcohol easily passes the placental barrier* -spontaneous abortion is 2 as likely to occur -there is no determination of a "safe" drinking level

Contingency management

A form of behavior therapy in which certain behaviors are reliably followed by well-defined consequences -In this approach, individuals receive immediate rewards (e.g., vouchers redeemable for goods or services) for providing drug-free urine samples, and the value of the rewards is increased with consecutive drug-free urine samples. -However, rewards are withheld if the client's urine sample is positive for an illicit drug.

What is the cause of schizophrenia in individuals?

Etiology of schizophrenia is unknown, but there is a clear genetic influence and enviornmental influence

Carbonation does what?

increases the rate by which the stomach empties its contents

Zyban (bupropion)

may be used alone or in combination with various forms of nicotine-replacement therapy to aid smoking cessation.

Strength of contingency management

one of the most important is that participants' drug-taking behaviors are being replaced with employable skills---> In this way, these programs ultimately pay for themselves as many who were formerly unemployable become tax-paying workers.

Life Skills Training Program & Project ALERT

Have had positive results--> decreased use of substances

What is one danger in using heavy amount of alcohol?

Higher mount of alcohol may indicate higher blood levels of acetaldehyde (which is quite toxic)

Distilled Spirits History & Process

History: -By 17th century- improved distillation techniques had made possible the production of relatively pure alcohol -Today's distilleries standard product is 95% pure ethyl alcohol (ethanol) (190 proof) Process: -into the process goes whatever grain is available at a cheap price and tank loads of corn syrup or other sources of sugars or starches--> at the other end, come grain neutral spirits, a clear liquid that is essentially tasteless (except for the strong alcohol taste)

How does the liver respond to chronic intake of alcohol?

It increases the activity of metabolic enzymes. Heavy alcohol use over time increases the activity of metabolic enzymes--> when the alcohol use stops, the high enzymatic levels continue for 4-8 weeks. *the increased activity of this enzyme is a partial basis for the tolerance to alcohol that is shown by heavy users of alcohol*

How was alcohol used until the late 19th century?

It was used as an anesthetic

Acute Behavioral Effects (4)

(1) Blackouts (2) Impairment of driving skills (3) Aggression & violence--> 95% of campus sexual assault involved the use of alcohol by either man, the woman or both (4) Sex and sexual desire--> 1 in 7 young ppl admits to having unsafe sex after drinking alcohol

What are 3 ways to lower the currents levels of alcohol related car accidents?

(1) Identify repeat offenders and keep them off the roads (2) Publicize the dangers of drinking and driving in mass media (3) Target younger drinkers for special prevention efforts

Signs of alcohol poisoning include:

(1) Person is unconscious or semiconscious (unable to answer simple questions) (2) Breathing rate is slow or irregular (3) Person's skin is cold and clammy, is pale, or has a bluish tinge (4) Person vomits and then loses consciousness

Prevention and treatment in the work place

-Employee Assistance Programs (EAP's) -Drug testing in the work place -Economic costs of AOD abuse -Impact of drug free workplace policies

Largest selling beer brands in the United States

(1) Bud Light, (2) Coors Light, (3) Budweiser *top brands falling into the light category*

Relationship between BAC & behavioral change- what are the two factors that will arise behavioral change?

(1) The rate at which BAC rises partly determines behavioral effects- the more rapid the increase, the greater the behavioral effects (2) a higher BAC is necessary to impair the performance of a chronic, heavy drinker than to impair a moderate drinker's performance *as BAC increases, the behavioral effects increase as well* 0.05 BAC- good feeling, yet impaired judgment 0.25 BAC- severe motor disturbance & great impairment 0.35 BAC- surgical anesthesia; minimal level causing death 0.40 BAC- 50% mortality level

Acute Physiological Effects (5)

(1) Toxic reaction --> LD50/ED50 ratio is relatively small (about 6), therefore not a very safe drug (2) Heat loss (3) Diuretic effects (4) Cardiovascular effects (5) Hangover

The term alcohol originates from what?

- Arabic word meaning: "finely divided spirit" and originally refereed to that part of the wine collected through distillation- the essence, or "spirit" of the wine

Alcohol Consumption: Regional Differences in the US

-1/3 of all US pop label themselves as abstainers -2/3 who use alcohol consume an amount that averages out to about 3 drinks per day -most don't drink that much, about 10% of the drinkers consume half of this alcohol -whites drink more than blacks / northerners more than southerners / younger adults more than older / Catholics & Jews more than Protestants / nonreligious more than religious, urban more than rural... etc -1/2 the total alcohol consumption comes from beer -New Hampshire & DC have highest per capita sales / New Hampshire & Nevada sell the most beer

AA effectiveness

-Formal evaluations of the success of AA have been few and have not been very positive. -For example, studies of court-ordered referrals to AA or to other types of interventions have not shown AA to be more effective.

Fermentation

-Forms the basis for all alcoholic beverages -Certain yeasts act on sugar in the presence of water--> this chemical action is fermentation -Yeast recombines the carbon, hydrogen and oxygen of sugar into ethyl alcohol and carbon dioxide

Alcohol as an evil force

-1884-1st writings were written by physician Benjamin Rush (one of the signers of the declaration of independence)- he noticed a relationship between heavy drinking and jaundice- referred to alcohol as a "disease" bc of it's addictive effects -other physicians noticed these symptoms and became the first leaders of the temperance movement -early 1800s- became fashionable for middle classes to join the elite in this movement -2nd half of 19th century- the waves of immigrants who entered the country provided the necessary consumption of beer (that otherwise would have not been preserved)--> drunken behavior became associated with immigrants (Irish, Italians, and eastern Europeans) -pressure grew & temperance advocaters moved for total abstinence from alcohol -1851- led to prohibition laws in states that continued until it became a national amendment in 1920 (ppl still drank illegally in speakeasies and legally through patent medicine that was freely available)

Treatment of Mental disorders before 1950

-1917: introduction of malaria therapy for general paresis (psychotic patients were mostly suffering from this disease)--> antibiotic that cured syphillis eliminated this treatment 1920's: "narcosis therapy" in which the use of barbiturates & other depressants was used to induce sleep in patients Another use for sedative drugs was in conjunction with psychotherapy: an intravenous dose of thiopental sodium, a rapid-acting barbitu- rate, would relax a person and produce more talking during psychotherapy--> known as truth serum 1933: insulin treatment for schizophrenia- used to either induce a coma or a convulsions- became a problem bc patients became very agitated after treatments 1938: Electroconvulsive Shock Therapy (ECT) replaced drug-induced seizures and came to be in widespread use in mental hospitals until the 1960s--> No long-term benefits for schizophrenia--> ECT turned out to be a rapid and effective way to reduce symptoms of depression. *ECT is still in use to treat severely depressed patients who do not respond to medication* 1950: Use of was paraldehyde, a sedative--> Although it produces little respiratory depression and therefore is safer than the barbiturates (strong odor)--> known as the "chemical straitjacket" bc it made patients slow down and be drowsy -Phenithiazines were also produced- which calmed ppl down--> THIS GROUP IS KNOWN AS ANTIPSYCHOTICS bc they reduce psychotic symptoms without producing drowsiness and sedation

Refusal Skills

-1980 -Focused on teaching students to recognize peer pressure to use drugs & on teaching specific ways to respond to such pressures without using drugs *This is sometimes referred to as psychological inoculation* -"Refusal skills" and "pressure resistance" strategies are taught in a broader context of self-assertion and social skills training.

History of Distillation- who discovered it? how were these products used for treatment of illnesses?

-800 AD- discovery of distillation in Arabia -10th century- only fermented beverages were used until this time period, then Italians first distilled wine (which introduced spirits to the western world) -On the continent, Europeans distilled wine into "brandywine", while the Irish and Scots distilled their malted-grain beverages (beer) into whiskey.

Maintenence

-A longer term strategy used to help the dependent individual avoid relapsing to the abused drug--> 3 major strategies used: 1. Antagonist or substitution therapy: induce cross-tolerance to the absorbed drug--> methadone is used to curve cravings 2. Antagonist Therapy: Used to produce extinction by preventing the user from experiencing the reinforcing effects of the abused drug (e.g., the opioid antagonist naltrexone, which selectively blocks opioid effects). 3. Punishment Therapy: punishment therapy is used to produce an aversive reaction following ingestion of the abused drug. Disulfiram (Antabuse) for the treatment of alcohol dependence is an example of punishment therapy.

Weaknesses of the contingency management approach

-A weakness of contingency management is the cost of the rewards, which could preclude the use of this procedure by small, less well funded treatment programs. -some people think it is unfair to those who "do the right thing" by not taking drugs to see drug users being paid to abstain from drug use.

Blood Alcohol Concentration (BAC) & Alcohol Intake

-Alcohol does not distribute much into fatty tissues: 180 pound lean person- lower BAC than a 180 pound fat person who drink the same amount of alcohol -requires no digestion and is absorbed unchanged into the bloodstream

Effects of Alcohol

-Alcohol effects the GABA receptors--> it enhances the inhibitory effects of the GABA at the GABA-A receptor -Alcohol is a CNS depressant -Alcohol has widespread inhibitory effects on the neurons in the brain -At high doses, alcohol also blocks the effects of the excitatory transmitter glutamate at some of its receptors

Disadvantages of alcohol use as an anesthetic

-Alcohol metabolizes slowly so it gives alcohol a long duration of action that cannot be controlled -The does effective in surgical anesthesia is not much lower than the does that causes respiratory arrest and death -Alcohol makes blood slower to clot

Monamube Oxidase Inhibitors (Antidepressant)

-Anti-tuberculosis meds that was meant to help treat tuberculosis but instead was too toxic and ended up killing people -proniazid is a monoamine oxidase (MAO) inhibitor *Although several MAO inhibitors have been introduced over the years, toxicity and side ef- fects have limited their use and have reduced their number.* -Iproniazid was removed from sale in 1961 after being implicated in at least 54 fatalities. -Currently two MAO inhibitors are on the U.S. market Limitation of the use of the MAO inhibitors: they alter the normal metabolism of a dietary amino acid, tyramine, such that if an individual consumes foods with a high tyramine content while taking MAO inhibitors, a hypertensive (high blood pressure) crisis can result -Because aged cheeses are one source of tyra- mine, this is often referred to as the "cheese reaction." -Symptoms: A severe headache, palpitations, flushing of the skin, nausea, and vomiting--> some cases ended in death from a stroke (cerebrovascular accident). -Mechanism of action: MAO MAO is an enzyme involved in the break- down of serotonin, norepinephrine, and dopamine, and its inhibition results in increased availability of these neurotransmitters at the synapse. This was the first clue to the possible mechanism of antidepressant action.

Antidepressant sale trends

-Antidepressant sales exceeded $15 billion in 2003--> sales in the declined slightly in 2004 & 2005 due to concerns about increased risk of suicide among children and adolescents -Analysis of data submitted to the FDA for approval of nine drugs found higher rates of suicidal thoughts among the drug groups than among the placebo controls--> so they began requiring a printed "black box" warning about the increased risk of suicidal tendencies in children and adolescents -Sales of selective reuptake inhibitors seemed back on track for further increases by 2006- led partly by their increasing use to treat generalized anxiety disorder. -By 2012, overall sales of antidepressants still totaled less than in 2003--> Because several of the most important antidepressants have recently become available in generic form--> profits are down and some companies seem to be switching their research focus away from these drugs to other opportunities

Mood Disorder- what is a depression & manic? How do you treat different mood disorders?

-Appearance of depressed or manic symptoms--> In simplistic terms, depression can be thought of as an abnormally low mood and mania as an abnormally high mood. -The important distinction in the drug treatment of mood disorders--> between bipolar disorder (in which at least one manic episode has occurred perhaps alternating with periods of depression) and major depressive disorder (in which only depressive episodes are reported).

Alcohol Use Issue in US

-At the time of the American Revolution against the English (late 1700s), most Americans drank alcoholic beverages and favored it over water (bc it was often contaminated) -The per capita consumption was greater than current levels

In American beer, the primary grain is _____. What is the process of creating it?

-Barley -Malted by steeping it in water and allowing it to sprout--> the sprouted grain is then slowly dried to kill the sprout but preserve the enzymes formed during the growth--> this dried. sprouted barley is called malt, and when crushed and mixed with water, the enzymes convert the starch to sugar--> ONLY YEAST is needed then to start fermentation *the LOWER sugar content of these grain-based beverages results in lower alcohol content- american beer typically contains 4% alcohol*

How to create naturally carbonated sparkling wine? How are inexpensive sparkling wines made?

-Bc carbon dioxide is produced during fermentation, carbonated sparkling wine can be produced by adding a small amount of sugar as the wine is bottled and then keeping the bottle tightly corked -carbon dioxide is injected into a generic wine during bottling

Alcohol poisoning

-CDC estimates that 2,220 ppl die each year to alcohol poisoning -the vomit reflex is triggered when BAC increases rapidly (usually above 0.12%) -Vomiting reflex is inhibited when BAC rises above 0.20, so it is possible to keep drinking a reach lethal concentrations

How can Cannabis withdrawal symptoms be relieved?

-Cannabis withdrawal symptoms can be relieved by the use of dronabinol, which shows promise as a treatment for cannabis dependence.

Prohibition (18th amendment)

-Cannot produce, sell or import alcoholic beverages in the US -1920 -The law did not result in an alcohol free society -The idea was nice, but the actual execution was not realistic for many -Prohibition did reduce overall alcohol intake (alcohol dependence & deaths from alcohol declined) -APPEALED by the 21st ammendment in 1933

How does chronic alcohol use and moderate alcohol use affect an individual?

-Chronic heavy alcohol use- lead to neurological damage & damage to heart/liver -Moderate drinking is associated w decrease in heart attacks

What are the two different types of antipsychotic drugs & what is the difference between the two?

-Conventional antipsychotics: the phenothiazines and most of the other drug types introduced before the mid-1990 (1st gen) -Atypical antipsychotics: All antipsychotics introduced in the past 10 years (2nd gen) *The atypical antipsychotics now dominate the market, with five of these drugs among the top 100 in prescription sales in 2010*

How do we classify mental disorders?

-Diagnostic & Statistical Manual of Mental Disorders (DSM-5)- provides criteria for classifying mental disorders into hundreds of specific diagnostic categories We define mental disorders based on: a. deviation from normal b. cultural criterion c. personal distress d. legal definition

How do you obtain alcohol concentrations above 15%? What is this process?

-Distillation -Is a process in which the solution containing alcohol is heated, and the vapors are collected and condensed into liquid form again. Alcohol has a lower boiling point than water, so there is a higher percentage of alcohol in the distillate (the condensed liquid) than there was in the original solution

Medications for alcohol

-Disulfram- oldest of these medical treatments and acts by interfering w/ the metabolism of acetaldehyde-> associates drinking w/ negative consequences bc if they drinking alcohol with this they may experience very unpleasant symptoms -Naltrexone- opioid antagonist that blocks the effect of drugs like heroin, but has been demonstrated to reduce cravings for alcohol -Acamprostate- reduces symptoms of protracted withdrawal and has been shown to help individuals w alcohol use disorder who have achieved abstinence go on to maintain it for several weeks to months

How does alcohol effect the nervous system?

-It depresses the central nervous system

Process of converting fruits and grains to alcohol?

-Fruits (grapes)--> contain sugar--> addition of yeast & water--> fermentation starts--> can create wine -Grain--> contain starch--> conversion of starch to sugar--> create malt (enzymes that convert starch to sugar)--> fermentation occurs--> can create beer

What are the two types of American wine examples of each)? How are they produced?

-Generics: *Chablis, Burgundy, and Rhine* Blended wines, made from whatever grapes are available, and during processing they are made to taste something lie the traditional European wines from those regions -Varietals: *Chardonnay & Merlot* Names after one variety of grape, which by law must make up at least 51% of the grapes used in producing wine. (more expensive than generics)

Heart disease due to alcohol

-Heavy alcohol use is associated w/ increased mortality resulting from heart disease -occurs bc of damage in the cardiopyopathy -also more likely to suffer from high blood pressure and strokes *moderate alcohol use seems to be the best option- increases lipoproteins ("good cholesterol") which protects against high blood pressure*

Alcohol Consumption in Different Cultures- Which countries have the highest alcohol consumption?

-In Russia & and Ireland, heavy drinking is the norm (especially distilled spirits): high rates of intoxication & alcohol-related problems -In Europe, wine consumption is the norm in a family setting, but drunkenness is discouraged *"extreme drinking" does not always correlate to overall alcohol consumption- europeans may drink wine in moderation with their families, but they manage to drink A LOT of wine* -Luxembourg, France, Ireland, Italy have the highest total per-capita alcohol consumption

Proof- What does this mean? Where did the word develop form?

-In the US, alcoholic content of distilled beverages is indicated by this term. -The % of alcohol by volume is one-half of the proof number *EXAMPLE: 90 proof whiskey = 45% alcohol* -The word developed from a British Army procedure to gauge the alcohol content of distilled spirits before there were modern techniques--> Process: Liquid was poured over gunpowder and ignited, if alcohol content was high enough, the alcohol would burn and ignite the gunpowder, which would go "poof" and explode--> *This would prove that the beverage had an acceptable alcohol content, about 57%.

Cognitive-behavioral therapy (CBT)- what is it? effectiveness? criticisms?

-Individuals learn to identify and change behaviors that may lead to continued drug use, such as going out to bars or associating with users. -CBT has been shown to be more effective at decreasing substance use than most standard psychotherapies, and the beneficial effects persist for as long as a year following treatment. *This approach is criticized for placing greater demands on the patients compared to other substance-abuse treatments, and it may be particularly challenging for individuals who have cognitive limitations.*

Parent & family programs

-Informational programs: Provide parents w/ basic info about alcohol and drugs, as well as information about their use and effects--> Although the parents often want to know simply what to look for, how to tell if their child is using drugs, and what the consequences of drug abuse are, the best programs provide additional info such as the context of drug use. - Family interaction approaches: approaches call for families to work as a unit to examine, dis- cuss, and confront issues relating to alcohol and drug use. Other exercises might include more general problem solving or response to emergencies. -Parenting skills programs: Communication with children, decision-making skills, how to set goals and limits, and when and how to say no to your child can be learned in the abstract and then practiced in role-playing exercises. -Parent support groups: Can be important adjuncts to skills training or in planning community efforts. Groups of parents meet regularly to discuss problem solving etc..

Detoxification

-Initial and immediate goal during which medications are administered to alleviate unpleasant withdrawal symptoms that may appear following abrupt cessation of drug use (e.g., the nicotine patch & nicotine gum have been used to treat individuals experiencing cigarette smoking abstinence symptoms). -Medications used in the detoxification phase are also sometimes used in the maintenance phase (e.g., nicotine replacement medications). -Thus, the distinction between a detoxification medication and a maintenance medication is sometimes less clear.

Antabuse (disulfiram)

-Interferes with alcohol metabolism to produce illness if the patient uses alcohol. -Naltrexone and acamprosate are also available to assist in preventing relapse.

Social Influence Method

-Introduced in Evan's 1976 smoking prevention paper -Possible to design smoking prevention programs that are effective in reducing the # of adolescents who begin smoking. -Presenting information about the delayed consequences of smoking (possible lung cancer many years later) is relatively ineffective--> Information about the immediate physiological effects (increased heart rate, shortness of breath) is included instead Most effective: -Training refusal skills (e.g., eight ways to say no). This was originally based on films demonstrating the kinds of social pressures that peers might use to encourage smoking and modeling a variety of appropriate responses. -Public commitment: Researchers found that having each child stand before his or her peers and promise not to start smoking and sign a pledge not to smoke are effective prevention techniques. -Use of Teen Leaders: bring a few high school students into the room and have them discuss the fact that neither they nor their friends smoke, their attitudes about smokers, and ways they have dealt with others' attempts to get them to smoke. Countering advertising: Students are shown examples of cigarette advertising, and then the "hidden messages" are discussed (young, attractive, healthy, active models are typically used; cigarette smoking might be associated with dating or with sports)--> Then the logical inconsistencies between these hidden messages and the actual effects of cigarette smoking (e.g., bad breath, yellow teeth, shortness of breath) are pointed out. Normative Education: Adolescents tend to overestimate the proportion of their peers who smoke. Presenting factual info about the smoking practices of adolescents provides students with a more realistic picture of the true social norms regarding smoking and reduces the "everybody is doing it" attitude.

What is the most significant date rape drug?

-Is & has always been alcohol -Women report having been sexually assaulted- had consumed alcohol

Antipsychotic use in children and elderly

-Large increase in the use of atypical antipsychotics in children to treat psychotic disorders, ADHD, and conduct disorder (for which they have not been approved- the last 2) -The reasoning seems to have been that because the newer drugs are less likely to produce the long-known & troublesome side effects of pseudoparkinsonism and tardive dyskinesia, they are "safer" than the older medications *However, a recent report indicates high risk of both weight gain and metabolic changes that signal increased risk for obesity, diabetes, and cardiovascular problems in children treated with the atypical antipsychotics* -Elderly patients treated with antipsychotic drugs--> often to control behavioral problems such as emotional outbursts/ inappropriate sexual acting out in institutionalized patients -In many cases these patients are suffering from dementia, and their uncontrolled behavior is a problem for their families, the staff, and the other patients *However, there is evidence of a significant increase in death risk from cardiovascular and other problems in elderly patients treated with the atypical antipsychotics*

How is beer made (process)? What distinguishes ales from lagers?

-Made by adding barley malt to other cereal grains, such as ground corn or rice--> the enzymes in the malt change the starches in these grains into sugar--> the solids are filtered out before yeast is added to the mash to start fermentation--> *hops (dried blossoms from only the female hop plant) are added with yeast to give beer its distinctive, pungent flavor. Lager: Fermentation originally took place in alpine caves, where the cooler temps made for slower fermentation--> yeasts tended to drop to the bottom of the mash--> this resulted in a selection process for types of yeast that work well as "bottom fermenters"--> *so modern lagers are made using bottom-fermenting yeasts, cool temperatures, and the slower fermentation. Ales have the lighter taste favored by most American beer drinkers.* Ale: *Made by using a top-fermenting yeast and slightly warmer temps, and shorter fermentation time results in more of the flavor of he malt being retained in the final product. Ales have a stronger taste.*

Values Clarification Approach

-Makes the assumption that what is lacking in drug-using adolescents is not factual information about drugs but, rather, the ability to make appropriate decisions based on that information. -Perhaps drug use should not be "flagged" for the students by having special curricula designed just for drugs but, instead, emphasis should be placed on teaching generic decision-making skills--> Teaching students to analyze and clarify their own values in life is accomplished by having them discuss their reactions to various situations that pose moral and ethical dilemmas. *often said to be value-free*

Gender differences in alcohol consumption

-Males are somewhat more likely to drink alcohol than females: 58% of males and 46% of females report current (past month) drinking -Males are almost 2x more likely to binge drink than females: 30% of males and 16% of females -Increasing proportion of males among the heaviest drinkers

Pharmacotherapies (medication treatments)

-Most experts do not believe that pharmacotherapies alone will cure a chronic, relapsing disorder such as substance abuse, in part, because the problem of substance abuse is expressed behaviorally--> Thus, a major hope is that pharmacotherapies will provide a window of opportunity by relieving withdrawal symptoms, for example, so that behavioral/ psychosocial treatments can be used.

Which food products can produce alcoholic beverages? How do each of them do this?

-Most fruits, including grapes: contain sugar and the addition of yeast to a mixture of crushed grapes and water will begin the fermentation process -Cereal grains: contain starch rather than sugar, and before fermentation can occur the starch must be converted to sugar--> the conversion happens by making malt (which contains enzymes that convert starch into sugar).

Long-Term Effectiveness of antipsychotics

-Most patients quit taking the assigned medication before reaching 18 months of treatment--> stopped because the drug did not appear to be helping & some stopped because the side effects became intolerable to them--> but the biggest single reason for stopping was "patient's decision." *In other words, in spite of short-term evidence of the efficacy of these drugs, their real-world effectiveness in chronic schizophrenia is considerably less than we had previously thought* The other surprising finding was that there was no clear evidence that the newer atypical agents worked any better than the conventional drug, nor were there significant differences in extrapyramidal symptoms.

Suicide & alcohol

-Most studies show that alcohol is involved in about 1/3 of all suicides -The relationship between the two is a strong one

Symptoms of a hangover include & effective remedies

-Nausea, upset stomach, headache, fatigue, sensitivity to noise, depression, anxiety, & general malaise -Effective remedies: analgesic for headache, rest, and time *some hangover symptoms may be a reaction to congeners*

History of Alcohol- who discovered it? which forms of alcohol were used throughout early history? oldest alcoholic beverage?

-Neolithic humans discovered booze: early use was seen worldwide (beer was drunk by the native americans whom columbus met) -8000 BC- Mead (made from honey) is the oldest alcoholic beverage -6400 BC- beer and berry wine were known and used -300 to 400 BC- grape wine was used

Wernicke-Korsakoff Syndrome

-Organic brain syndrome resulting from prolonged heavy alcohol use, involving confusion, ataxia (impaired coordination while walking), abnormal eye movements -Most severe-> korsakoff's psychosis- inability to remember recent events or learn never info -It may be caused by a deficiency of thiamine (vitamine b1), a vitamin metabolized poorly by heavy drinkers--> could be corrected nutritionally

US Alcohol Consumption

-Overall alcohol consumption increased through most of the 1970s, peaked in 1981 (reported use of illicit drugs peaked) -Beer consumption has declined since 1981, the most obvious change was the decline in the consumption of spirits before 1995 -Americans now consume just under 3/4 of a gallon of pure alcohol in the form of spirits, and about 1/3 of a gallon of alcohol per year in the form of wine -A total from all 3 beverage types of a little over two gallons of pure alcohol per person per year, down more than half a gallon from the 1981 peak.

The Biomedical Model

-Primary mode of therapy for most mentally ill patients revolve around drug therapy -Symptoms--> Diagnosis--> Find Cause --> Provide Cure -Abnormal thoughts and feelings are results of an abnormal biochemical process -We return biochemical processes towards a more normal state

Take Aways from the Prohibition after it was repealed

-Sales increased until after World War II, at which point per capita consumption was approx. what it had been before the prohibition -the prohibition of alcohol worked in reducing availability, but it did not close all the jails/mental hospitals, instead it encouraged organized crime & costed a crap ton to enforce

Prevention programs that have promise

-Social Influence Model -anxiety & stress reduction -DARE program

Absorption of Alcohol

-Some alcohol is absorbed from the stomach, but the small intestine is responsible for most of it -In an empty stomach, rate of absorption depends on the concentration of alcohol -Alcohol taken with/after a meal is absorbed more slowly bc the food remains in the stomach for digestive action, and the protein in the food retains the alcohol with it in the stomach -Plain water = slows the absorption of alcohol, carbon drinks = speed it up (example: champagne)

Side effects of antipsychotics

-Some allergic reactions might be noted such as jaundice or skin rashes. -Some patients exhibit photosensitivity -Some may get Agranulocytosis, low white blood cell count of unknown origin, can develop in the early stages of treatment. Because white blood cells are needed to fight infection, this disorder has a high mortality rate if it is not detected before a serious infection sets in -most common side effect of antipsychotic medication involves the nigrostriatal dopamine pathway--> The major effects include a wide range of movement disorders from facial tics to symptoms that resemble those of Parkinson's disease -The term tardive dyskinesia means "late-appearing abnormal movements" and refers primarily to rhythmic, repetitive sucking & smacking movements of the lips; thrusting of the tongue in and out ("fly-catching"); & movements of the arms, toes, or fingers. The fact that this syndrome usually occurs only after years of antipsychotic drug treatment, and that the symptoms persist and sometimes increase when medication is stopped, raised the possibility of irreversible changes.

Anxiety Disorders

-Specific phobia: excessive or unreasonable fear of a specific object or situation -Social Anxiety disorder: fear or anxiety about one or more social situations (meeting ppl, performing in front of others) -panic disorder: recurrent and unexpected panic attacks, intense fear or discomfort comes in surges. symptoms include- pounding heart, sweating, trembling, shortness of breath -agoraphobia- fear/anxiety about two of more of these situations: using public transportation, being in open spaces, being in shops or theaters, standing in line, or being outside of the home alone. -generalized anxiety disorder: excessive anxiety and worry about a number of events or activities such as school or work performance

Alcohol is most readily associated with which crimes of violence?

-Studies of assault, spousal abuse, & child abuse reveal correlations w/ drinking -Heavier drinkers are more likely to engage in such behaviors

Prevention approaches that have failed

-Supply reduction -Punitive measures -Knowledge-Attitudes Behavior Model -Affective Education -Anti drug norms

Sweet vs Dry Wine

-Sweet wines have a "heavier" taste overall, with the sweetness balancing out flavors that might be considered harsh in a dry wine. -*Sweet wines are labeled "extra dry"- the extra mean "not"*

Methadone

-The drug most commonly used to treat opioid dependence, although buprenorphine is now also available for use in substitution / maintenance treatment. -Naltrexone blocks the effects of any opioids the user might take, but it has not been as effective as methadone in helping people to abstain from heroin or other abused opioids. -Rapid opioid detoxification is a short-term method to avoid experiencing withdrawal symptoms.

How to produce a "light" beer?

-The mash is fermented at a cooler temp for a longer time, so that more of the sugars are converted to alcohol--> then the alcohol content is adjusted by adding water, resulting in a beverage with considerably less sugar and only a bit less alcohol *Light beers have 10% less alcohol and 25 to 30% fewer calories*

Possess of making American beer- sold in bottle or cans, what must be done to the yeast and why? How is this done?

-The yeast must be removed to prevent it from spoiling after packaging. -This is done by heating it (pasteurization), but some brewers use micro filters to remove the yeasts while keep the beer cold. -The carbonation is added at the time of packaging.

Most of the alcohol related car accidents are caused by who?

-They are caused by individuals who have not been identified as problem drinkers. -Almost 30% of the traffic fatalities happen in people in the age group of 21 to 24

How can performance drinkers perform task relatively easy?

-They have overcome the disruption of nervous system functioning -A regular drinker develops a tolerance in the CNS to alcohol

Trycyclic Antidepressant

-Tricyclic antidepressants were found in a search for better phenothiazine antipsychotics. -The basic phenothiazine structure consists of three rings, with various side chains for the different antipsychotic drugs--> Imipramine resulted from a slight change in the middle of the three rings and was tested in 1958 on a group of patients. Treatment effects: Little effect on psychotic symptoms but improved the mood of depressed patients--> This was the first tricyclic antidepressant, and many more have followed. -Although these drugs are not effective in all patients, most controlled clinical trials do find that depressive episodes are less severe and resolve more quickly if the patients are treated with one of the tricyclic antidepressants than if they are given a placebo. Mechanism of action: The first tricyclics were discovered to interfere with the reuptake into the terminal of the neurotransmitters norepinephrine, dopamine, and serotonin--> This results in an increased availability of these neurotransmitters at the synapse -Because MAO inhibition also results in increased availability of the same neurotransmitters, there has been considerable speculation that the antidepressant actions of both classes of drugs result from increased synaptic availability of one or more of these neurotransmitters.

Industrial uses of bulk grain neutral spirits are used for what purposes?

-Used for industrial purposes *example: large quantities of ethanol are added to gasoline to produce a less polluting fuel & ethanol used in cleaners and solvent -Used for beverage purposes *example: used in making beverages such as scotch whiskies & production of vodka* -Used for medicinal purposes *example: used for research*

Distilled Products used in Medicine

-Used to treat illnesses such as senility *The initial feeling about their medicinal value is best seen in the latin name given these condensed vapors by a 13th century french professor of medicine: aqua vitae, meaning "the water of life"

Mechanism of antipsychotic action

-Virtually all of the phenothiazines and other conventional antipsychotics produce pseudoparkinsonism--> Patients treated with these medications exhibit symptoms similar to Parkinson's disease (tremors and muscular rigidity). -initial effect of antipsychotic drugs is to block D2 dopamine receptors. However, this effect occurs with the first dose, but the anti- psychotic effect of these drugs is not seen for at least 10 to 14 days (the "lag period"). -Example: Clozapine blocked both d2 and serotonin receptors -Drugs are not addicting and relatively safe from over-dose potential

Congeners

-When alcohol is formed, other substances (such as congeners) are formed. -These may include alcohols other than ethanol, oils, and other organic matter. -Only present in small amounts, bc some them are quite toxic -Whiskey is usually distilled at a lower proof, not more than 160, and thus the distillate contains more congeners- this provides the variation in taste among whiskeys over time.

Examples of distilled beverages sold commercially. What is the percentage of alcohol in these products (a range)?

-Whiskey, vodka, gin, etc. -Range between 40% and 50% alcohol content (80 to 100 proof)

Does yeast have a limited tolerance for alcohol? (in relation to wine)

-Yes, when the concentration 15%, the yeast dies and fermentation ceases. -Up to 15% is theoretically possible, but the standard alcohol content for wine is about 12%.

Peer Programs

-Youth-oriented community service programs (ymca, ywca) -Peer Influence approaches- start with the assumption that the opinions of an adolescent's peers are significant influences on the adolescent's behavior--> Often using an adult group facilitator/coordinator, the program's emphasis is on open discussion among a group of children or adolescents. -Peer participation programs- focus on groups of youth in high-risk areas. The idea here is that young people participate in making important decisions and in doing significant work, either as "peers" with cooperating adults or in pro- grams managed almost entirely by the youth themselves.

Affective education--> Alternative to drugs

-involves the teaching of alternatives to drug use--> Under the assumption that students might take drugs for the experience (for the altered states of consciousness that a drug might produce)--> students are taught so-called natural highs, or altered states, that can be produced through relaxation exercises, meditation, vigorous exercise, or an exciting sport -Students are encouraged to try these things and to focus on the psychological changes that occur.

Alcohol Consumption in College

-the proportion of drinker is about 8% higher among 18-to-20 yr old college students than among others of that age -those who reported drinking after driving and binge drinking has decreased significantly due to prevention programs

Withdrawal from alcohol & progression of withdrawal (4 stages)

-the withdrawal from alcohol is medically more severe & more likely to cause death than withdrawal from opioid drugs--> detox should be done in a medical setting 1. Tremors, excessively rapid heartbeat, hypertension, heavy sweating, loss of appetite, insomnia 2. Hallucinations- auditory, tactile, or a combination of these 3. Delusions, disorientation, delirium, intermittent & usually followed by amnesia- DELIRIUM TREMENS 4. Seizure activity *medical treatment sought in stage 1 or 2, rapid intervention with sedative drug in stage 3 or 4

Alcohol's Physiological Affects (3)

1. Peripheral Circulation: Alcohol effects the CNS in the dilation of peripheral blood vessels-increase in heat loss makes the drinker feel warm- the heat loss & cooling of the interior of the body are enough to cause a slowdown in some biochemical processes- argues against giving alcohol to ppl in shock/extreme cold bc blood is needed & a heat loss is to be diminished if person is to survive 2. Fluid Balance: Alcohol effects the brain by decreasing the output of the anti-diuretic hormone (ADH, also called vasopressin) responsible for retaining fluid in the body- it is this effect, rather than the actual fluid consumption, that increases the urine flow in response to alcohol. This diuretic effect can lower blood pressure in some individuals 3. Hormonal effects: Even single doses of alcohol can produce measurable effects on a variety of hormonal systems- adrenal corticosteroids are release, as catecholamines from the adrenal medulla, and the production of the male sex hormone testosterone is supressed- chronic alcohol users can develop a variety of hormone-related disorders such as testicular atrophy and impotence in men and impaired functioning in women

Alcoholism is related to which 5 basic issues?

1. Problems associated with a preoccupation with drinking (binge drinking or symptomatic drinking) 2. Emotional problems 3. Vocational, social, family probs 4. Physical probs 5. Hiding the prob

Most wines contain about __% alcohol

12%

Drug-free Schools

1986 - federal gov launched a massive program to support "drug-free schools and communities" - policies made to point out through example what the school and community was opposed to; must teach that "illicit drug use is wrong and harmful"; trend away from "value-free" schools *as opposed to the 1970s values clarification approach of teach- ing students how to make responsible decisions for themselves, this approach wants to make it clear to the students that the society at large, the community in which they live, and the school in which they study have already made the decision not to condone drug use or underage alcohol use*

Major Depressive Disorder

A. For two weeks or more, five or more of the following, including either No. 1 or No. 2: 1. Depressed mood most of the day, nearly every day 2. Markedly diminished interest or pleasure in most activities 3. Significant changes in body weight or appe- tite (increased or decreased) 4. Insomnia or hypersomnia nearly every day 5. Psychomotor agitation (increased activity) or retardation (decreased activity) 6. Fatigue or loss of energy 7. Feelings of worthlessness or excessive guilt 8. Diminished ability to think or concentrate 9. Recurrent thoughts of death or suicide, or a suicide attempt or plan for committing suicide B. The symptoms cause clinically significant distress or impairment C. Not due to a drug or medical condition and not a normal reaction to the loss of a loved one

Homicide

About 1/2 of those who committed homicide were "under the influence"

How is alcohol removed by the liver?

Alcohol is removed by the liver at a constant rate of 0.25 to 0.30 ounce of ethanol per hour *most ppl fall within this range no matter what their body size or drinking experience, unless they have consumed so much alcohol that the liver is damaged* (this is about half of our standard drink- 1 beer, shot, or glass of wine) *over the course of an evening, if your rate of intake = rate of metabolism--> stable BAC* *if you drink fast than one drink every two hours, your BAC will climb*

Cocaine dependence treatment

Although recent findings with modafinil have been encouraging, no medication has yet been developed specifically for treatment of cocaine dependence

How alcohol effects sexual desire in men & women?

Both Men & Women: -both agree that alcohol enhances or disinhibits sexuality; both reported more arousal after drinking Men: -men become less aroused as BAC increases Alcohol is linked with risky sexual behavior, early sexual behavior, unprotected sex, and increases the likelihood of sexual assault. *one in 7 young ppl admits to having unsafe sex after drinking alcohol*

What causes depression?

Chemical NT's imbalance, hereditary, personality--> how these factors interact is not known

How is wine made? (Six)

Crushing- breaking grape sins into must Macerating- soaking must in grape skins (red- skins left for both rounds of ferm; rosé- only first; white- never) Pressing- removing any solid matter from must Primary Ferm- sugars->alc Secondary Ferm- makes wine less acidic Bottling

From the peak of almost 60% in 1982, alcohol related traffic crash fatalities has _____________.

Decreased to less than 40%.

Which neurons does alcohol effect?

Dopamine, Serotonin, and Acetylcholine

Binge Drinking

Drinking five or more alcoholic drinks at one sitting

DARE

Drug Abuse Resistance Education is a program, originated in 1984 by the Los Angeles Police Department, under which uniformed police officers visit elementary school classrooms throughout the United States. -This program for fifth- and sixth-graders involves 17 weekly lessons, with titles such as "Drug Use and Misuse," "Resistance Techniques: Ways to Say No," "Building Self-Esteem," "Managing Stress Without Taking Drugs," and "Media Influences on Drug Use."

Strategies for Tertiary Treatment

Drug Treatment & the Criminal Justice System -The concepts pf rehabilitation and deterrence -Prevention through law enforcement -Incarceration -Prison-alternative and prison-based treatment programs

The primary metabolic system

Enzyme alcohol dehydrogenase converts alcohol to acetaldehyde--> acetaldehyde converts rapidly by aldehyde dehydrogenase to acetic acid *With alcohol, the amount that can be metabolized is constant at about 0.25 to 0.30 ounces per hour regardless of the BAC*

Compared with men, women absorb a ___________ proportion of the alcohol they drink.

Greater *some metabolism of alcohol actually occurs in the stomach, where the enzyme alcohol dehydrogenase is present--> bc this stomach enzyme is more present, on avg, in men than in women, women might be more susceptible to the effects of alcohol.*

The spiral model of stages of change: Motivational Enhancement Therapy

Motivational Enchancement Therapy-> attempts to shift the focus away from denial and toward motivation to change 1.PRECONTEMPLATION (people not considering changing their problem behavior); 2.CONTEMPLATION (entails the individuals beginning to consider both that they have a problem and the feasibility and costs of changing that behavior); 3.DETERMINATION (the decision is made to take action and change); 4. ACTION (the individual begins to modify the problem behavior; this stage normally continues for 3-6 months); 5. MAINTENANCE (sustained change); If these efforts fail, a 6. RELAPSE occurs, after which the individual begins another cycle.

Is alcohol considered a stimulant?

No, most scientists would say that alcohol is associated with a decreased inhibition of behavior

Are substance use treatments effective (broadly)?

Overall, substance-abuse treatment pro- grams are considered to be effective because they do help many people to ab- stain, sometimes only for a few months, but often for many years. *The benefits far exceed the cost of providing the programs.*

The Knowledge-Attitudes Behavior Model

PREVENTION IN THE SCHOOLS -presentation by police, former drug user, or pharmacologist -increase student knowledge about drugs will.... -change their attitudes and these changed attitudes will.... -decrease drug-using behavior -Programs typically involve presentations by police and former users. -Often include traditional scare tactics and/or pharmacological information. -Approach assumes that increasing student knowledge about drugs will change their attitudes and that these changed attitudes will be reflected in decreased drug-using behavior. *These efforts took a hault in the early 1970's bc drug use was increasing in schools--> lead ppl to believe that educating kids might be the reason for this increase*

Alcohol induced blackouts

Periods in which the drinking individuals appears to function normally but later, when the individual is sober, he or she cannot recall any events that occurred during that period

Prevention Strategies

Primary prevention: Aim: Programs are those aimed mainly at young people who have not yet tried the substances in question or who may have tried tobacco or alcohol a few times. Encourage abstinence from specific drugs or explain how drugs would influence their lives. Danger: Giving loads of information about drugs to children may expose them to info they never would have heard about/arouse their curiosity Secondary Prevention: Aim: Programs can be thought of as designed for people who have tried the drug in question or a variety of other substances. Try to prevent people from using other more dangerous substances---> many college students fall under this category Tertiary Prevention: Aim: Relapse prevention--> for alcohol & heroin dependent individuals. However, once a person has been treated or has stopped the sub- stance use without assistance, we enter another stage of prevention. Universal Prevention: Programs are designed for delivery to an entire population— for example, all schoolchildren or an entire community. Selective Prevention: strategies are designed for groups within the general population that are deemed to be at high risk—for example, students who are not doing well academically or the poorest neighborhoods in a community. Indicated Prevention: Strategies are targeted at individuals who show signs of developing problems, such as a child who began smoking cigarettes at a young age or an adult arrested for a first offense of driving under the influence of alcohol.

The "Demon Run" Programs

Programs in the late 1800s that only sought to present negative information about drugs, rather than educating public schools about them--> CLEAR GOAL IN MIND: Prevention of use - some of these programs presented information that was clearly one-sided that they could have been classified as propaganda

Community Based Prevention Programs

Provide alternative student activities

Alcohol was the first _________________.

Psychoactive substance to become demonized in American culture & still affects American culture today- lead the way for similar views of cocaine, heroin, and marijuana

Psychosis- what is it? what are the different types?

Refers to a major disturbance of normal intellectual and social functioning in which there is loss contact with reality -this can mean: not knowing the current date, hearing voices that aren't there, and believing that you are napolean or christ Two different types: Organic psychoses- which can result from a brain tumors, infections, matabolic disoders, etc Functional psychoses- disorder in which there is no known or obvious physical cause--> *a person suffering from chronic psychotic condition for which there is no known cause will probably receive the diagnosis of schizophrenia

Personal and social skills

Several studies indicate that adolescents who smoke, drink, or use marijuana also get lower grades and are less involved in organized sports or school clubs--> One view of this is that students might take up substance use in response to personal or social failure--> *Therefore, teaching students how to communicate with others and giving them success experiences is another component of affective education approaches.*

As the risk of being involved in a alcohol related car crash increases, ______________.

The BAC levels increase as well *BAC at 0.08-0.10 make you more than twice as likely to occur*

What is the major factor that determines the rate at which alcohol metabolizes?

The activity of the enzyme alcohol dehydrogenase. *exercise, coffee consumption, and so on have no effect on this enzyme--> sobering up is a matter of waiting for this enzyme to do its job at its own speed*

How does alcohol leave the bloodstream?

The alcohol must be metabolized- more than 90% of this metabolism occurs in the liver; less than 2% is excreted unchanged (some in breath, through skin, and in urine)

Temperance Movement

The idea that ppl should drink beer or wine in moderation, but drink no hard liquor

Selective Reputake Inhibitors Antidepressant

The introduction in 1987 of fluoxetine (Prozac) ushered in the era of the selective serotonin reuptake inhibitors (SSRIs) -Prozac is safer than the tricyclic antidepressants in that it is less likely to lead to overdose deaths, so physicians felt more confident about prescribing it -Despite some reports in the early 1990s of unusual violent/suicidal reactions, sales of Prozac continued at a high rate -Drugs have also been developed that are reuptake inhibitors for both serotonin and norepinephrine--> in that sense they are similar to the older tricyclics, but these newer drugs are more selective (have fewer other actions than the tricyclics), and are thus referred to as SSNRIs

Bipolar I Disorder

The key to a diagnosis of bipolar I is the presence of a manic episode, defined by: A. Abnormally and persistently elevated, expansive, or irritable mood B. At least three of the following: 1. Inflated self-esteem or grandiosity 2. Decreased need for sleep 3. More talkative than usual or pressure to keep talking 4. Flight of ideas or feeling that thoughts are racing 5. Distractibility 6. Increase in activity 7. Excessive involvement in pleasurable activities that have a high potential for painful consequences (shopping, sex, foolish investments) C. Mood disturbance is sufficiently severe to cause marked impairment in functioning

Strengthening Families Program- what is it? what are their goals?

This program has been successfully implemented several times within diverse populations. It has three major goals: 1. improving parenting skills 2. increasing children's skills (such as communication skills, refusal skills, awareness of feelings, and emotion expression skills) 3. improving family relationships (de- creasing conflict, improving communication, increasing parent-child time together increasing the planning and organizational skills of the family).

Diagnosis of schizophrenia

Two or more of the following, including at least one of the first three: 1. Delusions (irrational beliefs) 2. Hallucinations (e.g., hearing voices) 3. Disorganized speech (incoherent, frequent changes of topic) 4. Grossly disorganized behavior (inappropri- ate, unpredictable) or catatonic (withdrawn, immobile) 5. Negative symptoms (lack of emotional re- sponse, little or no speech, doesn't initiate activities) B. Interference with social or occupational function C. Duration of at least six months

Death resulting from acute alcohol intoxication is usually the result of what?

Usually the result of respiratory failure when the medulla is depressed

Difference between white, red, and pink wines

White- made from white grape, although it is possible to use red grapes if the skins are removed before fermentation Red- made frm red grapes by leaving the skins in the crushed grapes while they ferment -Pink- made from red grapes where the skin is left on the crushed grapes for a short while

Balanced Placebo Design

a study design in which behavioral effects are observed following the presence or absence of alcohol in order to determine effects on participants *Found that social behavior are strongly influence by the belief that one has consumed alcohol (even when none is consumed)* *Impairment in reaction times & driving simulators result from actual alcohol consumption